Post-Traumatic Stress Disorder (PTSD)

Post-Traumatic stress disorder (PTSD) is an anxiety disorder that can occur after the Veteran experiences a traumatic event. During this type of event, the Veteran believes his/her life or others' lives are in danger. She/he may feel afraid or feel that they have no control over what is happening. Note: this information is described as applying to Veterans, but is applicable to any individual. Anyone who has gone through a life-threatening event can develop PTSD. These events can include:

Combat or military exposure

Child sexual or physical abuse

Terrorist attacks

Sexual or physical assault

Serious accidents, such as a car wreck

Natural disasters, such as a fire, tornado, hurricane, flood, or earthquake

After the event, the Veteran may feel scared, confused, or angry. If these feelings don't go away or they get worse, the symptoms may disrupt the person’s life, making it hard to continue daily activities. All Veterans with PTSD have lived through a traumatic event that caused them to fear for their lives, see horrible things, and feel helpless. Strong emotions caused by the event create changes in the brain that may result in PTSD. Most Veterans who go through a traumatic event have some symptoms at the beginning. Yet only some will develop PTSD; the reason for this is not clear. How likely someone is to get PTSD depends on many things:

How intense the trauma was or how long it lasted

If someone close was lost hurt

Proximity to the event

Strength of the reaction to the event

How much the Veteran felt in control of events

How much help and support the Veteran got after the event

Many who develop PTSD may improve, though about 1 out of 3 with PTSD may continue to have some symptoms. Even with continued symptoms, treatment can help; symptoms don't have to interfere with everyday activities, work, and relationships.

Symptoms of PTSD
PTSD symptoms usually start soon after the traumatic event, but they may not occur until months or years later. They also may come and go over many years. If the symptoms last longer than 4 weeks, cause great distress, or interfere with work or homelife, the individual probably has PTSD. There are four types of PTSD symptoms:

1. Reliving the event (also called re-experiencing symptoms):
Bad memories of the traumatic event can return at any time. The Veteran may feel the same fear and horror as when the event took place. He/she may have nightmares or may feel like he/she is going through the event again. This is called a flashback. Sometimes there is a trigger -- a sound or sight that causes the Veteran to relive the event. Triggers might include:

Hearing a car backfire, which can bring back memories of gunfire and war for a combat Veteran.

Seeing a car accident, which can remind a crash survivor of his or her own accident

Seeing a news report of a sexual assault, which may bring back memories of assault for a woman who was raped

2. Avoiding situations that are reminders of the event:
The Veteran may try to avoid situations or people that trigger memories of the traumatic event, and even avoid talking or thinking about the event. For example:

A person who was in an earthquake may avoid watching television shows or movies in which there are earthquakes.

A person who was robbed at gunpoint while ordering at a hamburger drive-in may avoid fast-food restaurants.

Some people may keep very busy or avoid seeking help. This keeps them from having to think or talk about the event.

3. Feeling numb:
The Veteran may find it hard to express feelings. This is another way to avoid memories. He/she may not:

have positive or loving feelings toward other people and may stay away from relationships

be interested in previously enjoyed activities

be able to remember parts of the traumatic event or be able to talk about them

4. Feeling keyed up (also called hyper-arousal):
The Veteran may be jittery, or always alert and on the lookout for danger. This is known as hyper-arousal. It can cause:

Sudden anger or irritation

Difficulty sleeping and concentration

Fear for personal safety and a constant need to be on guard

Overreaction when something surprises him/her.

Other common problems
People with PTSD may also have other problems. These include:

Drinking or drug problems

Feelings of hopelessness, shame, or despair

Employment problems

Relationship problems, including divorce and violence

Physical symptoms

Treatment
When a Veteran has PTSD, dealing with the past can be difficult, and feelings are generally kept “bottled up”. Treatment must be provided by qualified hospice or VA staff. See PTSD Related Resources for additional information.